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D F Williamson

Publications and source records attributed to D F Williamson.

119 records · Page 7Linked to original sources
PubMed1988

Alcohol use and health behavior lifestyles among U.S. women: the behavioral risk factor surveys.

Alcohol use is a complex behavior, occurring in the context of an overall health lifestyle. We used data from a nationally representative telephone survey (N = 12,467 women) to examine associations between binge drinking, chronic drinking, and other health behaviors. Certain health-risk behaviors (e.g., smoking, drunk driving, and seatbelt nonuse) tend to cluster with alcohol misuse. These may act synergistically, thus augmenting the negative health effects of alcohol misuse. Conversely, some health behaviors (e.g., eating or exercising, particularly in response to stress) are negatively associated with alcohol misuse and may serve similar functions for some women. Finally, binge drinking occurs more frequently among women who may have relatively restrictive eating behaviors and higher levels of interpersonal stress. Our findings suggest that alcohol prevention and treatment programs should address sociodemographic and health lifestyle factors that initially predispose an individual to engage in health-risk behaviors and should recognize the interdependent patterns of behaviors associated with alcohol misuse. This approach will help prevent substitutions, recurrence, or induction of detrimental behaviors and will identify potentially negative interactions between existing concurrent health-risk behaviors.

Adolescent↗
PubMed1987

Alcohol and body weight in United States adults.

Alcohol contributes more than 10 per cent of the total caloric intake of adult drinkers in the United States. However, the effect of alcohol on body weight has not been adequately studied in the general population. The association between weight and frequency of alcohol consumption was examined in two national cross-sectional surveys: the Second National Health and Nutrition Examination Survey (HANESII; n = 10,929) and the Behavioral Risk Factor Surveys (BRFS; n = 18,388). Linear multiple regression was used to estimate the independent effect of alcohol on weight, adjusting for smoking, age, diet practices, physical activity, race, education, and height. Among men, alcohol had only a slight effect on weight in either survey. However, among women, alcohol was associated with a substantial reduction in weight, which was as large as the effect of smoking. Compared with nondrinkers, women who consumed alcohol 7-13 times per week had the greatest reduction in weight: -3.6 kg (95% confidence limits [CL] = -5.6, -1.5 kg) in HANESII and -3.2 kg (95% CL = -4.9, -1.5 kg) in BRFS. Alcohol confounded the association between smoking and weight, and among women it accounted for nearly 45 per cent of the weight-lowering effect of smoking. Alcohol also diminished the weight-lowering effect of smoking in men, while in women the smoking effect was slightly enhanced. Further studies are needed to understand the causal mechanisms by which alcohol is associated with body weight.

Adult↗
PubMed1987

Continuance of elderly on home-delivered meals programs.

Data from 2,002 elderly receiving home-delivered meals in 23 counties of New York State in 1984-85 were analyzed using a baseline survey and a six-month follow-up survey. Survival analysis estimated that 37.4 per cent of the clients left the program by the follow-up. The initial drop-out rate was estimated to be 14.2 per cent per month; by six months the rate fell to 3.3 per cent. Whites left the program at a rate 2.6 times (95% CI = 1.9, 3.8) that of minorities. Recent discharge from hospital was associated with the highest relative probability of program discontinuance (2.7, 95% CI = 2.2, 3.4), followed by having cancer (2.1, 95% CI = 1.6, 2.8), and having a non-hip fracture (2.0, 95% CI = 1.3, 2.9). Many of those with cancer died, while those recently discharged and those with non-hip fractures were more likely to leave the program because they were again able to cook for themselves.

Aged↗
PubMed1987

Validity of clinic-based nutritional surveillance for prevalence estimation of undernutrition.

Few studies have been performed to assess the validity of clinic-based nutritional surveillance systems. We compared estimates of the prevalence of underweight (low weight-for-age) obtained from the clinic-based Swaziland surveillance system with estimates obtained from the 1983 National Nutrition Status Survey of Rural Swaziland. The age-adjusted prevalence of underweight among first-time clinic attenders (10.0%) was very similar to that estimated by the national survey (9.4%). However, the prevalence of underweight among children attending two or more times in a year was less than half that of first attenders (4.4%). The regional differences in the prevalence of underweight found in the national survey were not detected by the surveillance system. Surveillance data are useful in describing the nutritional status of children from clinics within the surveillance system. However, surveillance data, particularly from re-attenders, will not necessarily provide a valid estimate of nutritional status within the general population or of differences between regions.

Age Factors↗
PubMedDate not supplied

Epidemiologic analysis of weight gain in U.S. adults.

Although the prevalence of overweight as estimated from nationally representative cross-sectional studies is well documented, much less is known about the incidence of overweight and major weight gain in United States adults. I review results from the First National Health Examination Follow-Up Study involving 9862 people aged 25-74 yr who were first weighed between 1971 and 1975 and reweighed 10 yr later between 1982 and 1984.

Adult↗
PubMedDate not supplied

Smoking prevalence in the United States and Taipei City, Taiwan.

Although there are extensive antismoking efforts in the United States, smoking is a largely ignored health issue in Taiwan. In fact, tobacco advertising has increased dramatically since U.S. tobacco was first imported in 1987. We compared estimates of smoking prevalence of 83,281 Americans and 5,023 persons in Taipei, Taiwan, in 1986-1988. Among men, current smoking prevalence was higher in Taipei (49%) than in the United States (29%). In contrast, former smoking prevalence among men was substantially lower in Taipei (5%) than in the United States (32%). Young adults and those with lower and middle education levels had the highest smoking prevalence in both surveys. Among women, the current smoking prevalence was only 8% in Taipei, compared to 25% in the United States. The former smoking prevalence among Taipei women (1%) was also lower than among U.S. women (18%). Our findings indicate the need for expanding antismoking efforts in Taiwan, especially among men and among persons with lower and middle education levels.

Adolescent↗
PubMedDate not supplied

Design, characteristics, and usefulness of state-based behavioral risk factor surveillance: 1981-87.

Since 1981, the Centers for Disease Control has collaborated with State health departments and the District of Columbia to conduct random digit-dialed telephone surveys of adults concerning their health practices and behaviors. This State-based surveillance system, which yields data needed in planning, initiating, and supporting health promotion and disease prevention programs, is described in this paper. Standard methods and questionnaires were used to assess the prevalence of personal health practices and behaviors related to the leading causes of death, including seatbelt use, high blood pressure control, physical activity, weight control, cigarette smoking, alcohol use, drinking and driving, and preventive health practices. Between 1981 and 1983, 29 States (includes the District of Columbia) conducted one-time telephone surveys. Beginning in 1984, most States began collecting data continuously throughout the year, completing approximately 100 interviews per month (range 50-250), with an average of 1,200 completed interviews per year (range 600-3,000). The raw data were weighted to the age, race, and sex distribution for each State from the 1980 census data. This weighting accounts for the underrepresentation of men, whites, and younger persons (18-24 years) in the telephone surveys and, for many health practices, provides prevalence estimates comparable with estimates obtained from household surveys. Nearly all (86 percent) of the States distributed selected survey results to other State agencies, local health departments, voluntary organizations, hospitals, universities, State legislators, and the press. The majority (60 percent) of States used information from the surveys to set State health objectives, prepare State health planning documents, and plan a variety of programs concerning antismoking, the prevention of chronic diseases, and health promotion. Further, nearly two-thirds (65 percent) used results to support legislation, primarily related to the use of tobacco and seatbelts. Most of the States (84 percent) reported that alternative sources for such data (prevalence of behavioral risk factors) were unavailable. Currently in 1988, over 40 State health departments are conducting telephone surveys as part of the Behavioral Risk Factor Surveillance System. This system has proved to be (a) flexible--it provides data on emerging public health problems, such as smokeless tobacco use and AIDS, (b) timely--it provides results within a few months after the data are collected, and (c) affordable--it operates at a fraction of the cost of comparable statewide in-person surveys. The system enables State public health agencies to continue to plan,initiate, and guide statewide health promotion and disease prevention programs and monitor their progress over time.

Adolescent↗
PubMedDate not supplied

The 25-year health care costs of women who remain overweight after 40 years of age.

BACKGROUND AND PURPOSE: Previously published reports strongly suggest that being overweight is a risk factor for coronary heart disease, hypertension, diabetes, gallstones, and osteoarthritis in women. Substantial health care and medication costs are associated with these chronic health conditions. We used an incidence-based analysis to estimate the excess costs associated with women maintaining an overweight status during the 25-year period from age 40 to 65 years. METHODS: The health care costs of three hypothetical cohorts of 10,000 40-year-old women were extrapolated to age 65. The non-overweight cohort maintained a body mass index (BMI; weight [kg]/height [m2]) of 21 to 24.9; the moderately overweight cohort maintained a BMI of 25 to 28.9; the severely overweight cohort maintained a BMI of > or = 29. The number of fatal and nonfatal health outcomes in each cohort for heart disease, hypertension, diabetes mellitus, gallstones, and osteoarthritis was calculated with their associated costs. RESULTS: We estimated that when compared with the non-overweight cohort of 10,000 women, the cohort of 10,000 women who had a BMI of > or = 29 incurred excess costs of $53 million over a 25 year period (discounted at 3% per year) and 497 excess deaths. The cohort of 10,000 women who had a BMI of 25-28.9 incurred excess costs of $22 million (discounted at 3% per year) and 212 excess deaths, compared with the non-overweight cohort. CONCLUSIONS: The results of this study indicate that an estimated $16 billion will be spent during the next 25 years treating health outcomes associated with overweight in middle-aged women in the United States. Thus, a substantial health burden is associated with the increasing prevalence of overweight women in the United States. Preventing excess coronary heart disease, gall-stones, osteoarthritis, hypertension, and diabetes through prevention of weight gain, particularly among reproductive-aged women, may be a cost-effective strategy.

Adult↗